Provider Demographics
NPI:1558698373
Name:SICKELS, LAURA SUZANNE (NMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:SUZANNE
Last Name:SICKELS
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7857 N COLTRANE LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7331
Mailing Address - Country:US
Mailing Address - Phone:520-444-4930
Mailing Address - Fax:520-579-0476
Practice Address - Street 1:6514 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2117
Practice Address - Country:US
Practice Address - Phone:520-444-4930
Practice Address - Fax:520-579-0476
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ05-899175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath